Factors Influencing Treatment Options for Stage 1B Grade 3 Endometrial Cancer

David Barrington, MD, obstetrics & gynecology specialist at Ohio State University Comprehensive Cancer Center, discusses the key takeaways regarding the factors associated with variation of adjuvant treatments for patients with stage 1B, grade 3 endometrial cancer.

While the NCCN guidelines show there to be a number of treatment options, including external beam radiation and adjuvant chemotherapy for this patient population, the standard of care remains unknown.

Through the examination of data from the National Cancer database, Barrington and other experts aimed to discover whether or not factors such as race, facilities, or region were associated with variation, treatment patterns and resulted in different recommendations for patients.

While findings showed no differences based on race and that there may be a survival benefit for patients in the academic setting using multimodal therapies, confusion surrounding what the optimal treatment for these grade 3 tumors are. Further studies are needed to determine the proper ways to manage these patients. to really elucidate what's going to be the proper way to manage these patients moving forward.

Transcription:

0:08 | Knowing the latitude that NCCN allows for adjuvant treatment for these 1B grade 3 endometrial cancers, we want to examine using data from the National Cancer database to see if we can identify factors that were associated with variation and treatment patterns. If there were differences around the country, or based on the type of facility, or racial demographics to see if we saw differences in what was being recommended.

0:41 | We saw that certain regions and the more academic institutions were more likely to use a combination of a multimodal therapy with chemotherapy, plus or minus radiation, including external beam radiation or vaginal breaking therapy. We saw from the database, data that seemed to be a survival benefit. Of course, it's difficult to interpret these database studies because it's all retrospective in nature and doesn't control for all confounding bias, but [they are] interesting findings.

1:19 | Specifically, we saw that while there was no difference based on race, whether or not multimodal therapy was employed, the Black woman that received combined therapy, chemotherapy plus radiation, seemed to have a greater survival benefit than what we saw in other racial groups.